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Alteplase Alaris Infusion Pump Programming Instructions for Acute STEMI

Alteplase Alaris Infusion Pump Programming Instructions for Acute STEMI - Clinical Hub, UW Health Clinical Tool Search, UW Health Clinical Tool Search, Order Sets, Inpatient, Cardiology/CT Surgery, Related


Alteplase Alaris Infusion Pump Programming Instructions For
Acute STEMI ONLY
TOTAL ALTEPLASE DOSE FOR TREATMENT OF STEMI IS 100 mg given as a 15 mg bolus followed by a 50
mg infusion and a 35 mg infusion*.
*NOTE:
• Other dosing regimens exist for STEMI
• Review Health Link order to ensure dosing instructions for Acute STEMI match dosing listed ON THIS
SHEET
• If dose ordered is different, disregard the following instructions.
STEMI Thrombolytic Therapy – Alteplase:
• Recommended total dose is 100 mg infused over 90 minutes
• Infused via 4 step process using the Alaris pump
Step Action
1 15 mg bolus via Alaris pump rapid bolus feature (infused in 1-2 minutes)
2 50 mg infused over 30 minutes
3 35 mg infused over 60 minutes
4 Med line flush with normal saline
Nursing Administration Procedure:
1. Important
a. Alteplase is a High Alert medication requiring a second independent verification for pump
programming (UW Administrative Policy 8.33, High Alert Medication Administration)
b. Do not add other medication to the Alteplase bag/vial or tubing
c. Administer alteplase through a dedicated lumen
d. This is a primary infusion, do not set up as a secondary
2. Equipment and supplies
a. Alaris programming unit
b. Alaris pump module
c. Alaris primary tubing set (Use NEW primary tubing set for administration of alteplase)
d. Alteplase 100 mg/100 mL bag/vial
e. 50 mL normal saline minibag
3. Prepare infusion
a. Prime tubing SLOWLY with alteplase; ensure there is no air in tubing
b. Do not waste medication during priming as there is no overfill in the alteplase bag/vial
c. If alteplase is supplied in a glass vial, open vent on tubing drip chamber to facilitate priming
and infusion from the vial
4. Pump setup
a. Select Adult ICU profile on infusion pump
b. Select “alteplase” in Guardrails drug library
c. Press Page Down; select “STEMI” from next page
Copyright © 201� University of Wisconsin Hospitals and Clinics Authority
Contact: Lee Vermeulen, CCKM@uwhealth.org Last Revised: 09/2016CCKM@uwhealth.org Page 1 of 2

5. Steps 1 and 2 programming sequence
a. Press VTBI; enter 65 mL
b. Press Rate; enter 100 mL/hr
c. Press Bolus soft key
d. Enter dose: 15 mg
e. Press Duration; press Rapid Bolus
f. Press Start (Bolus will be delivered first. Pump automatically switches from bolus to
programmed infusion (step 2))
6. Pump will issue an “Infusion Complete” alert when 65 mL VTBI has been administered
7. RN must stay at bedside to complete remainder of procedure
8. Step 3 programming sequence
a. Press VTBI; enter 35 mL**
b. Press Rate; enter 35 mL/hr
c. Press Start
** IMPORTANT – Bag/vial will empty before 35 mL VTBI is completed! Do not allow drip
chamber to empty; RN must be in room to anticipate bag/vial depletion and to start step 4
9. Step 4 programming sequence
a. Remove spike from empty alteplase container
b. Place spike in 50 mL normal saline minibag
c. Do not add additional VTBI. Normal saline will flush all alteplase from tubing set to the
patient
d. Pump will issue an “Infusion Complete” alert when 35 mL VTBI has been administered;
Disconnect tubing and discard
Copyright © 201� University of Wisconsin Hospitals and Clinics Authority
Contact: Lee Vermeulen, CCKM@uwhealth.org Last Revised: 09/2016CCKM@uwhealth.org Page 2 of 2
These instructions are to be used in conjunction with orders placed via order set ED/IP - STEMI
Thrombolytic Therapy - Adult - Supplemental [6081]. For content questions, contact Carin
Endres at cendres2@uwhealth.org. For other questions, please contact CCKM at cckm@uwhealth.org.